ORIGINAL CONTRIBUTION Circulating Androgen Levels and Self-reported Sexual Function in Women

SEXUAL DYSFUNCTION, PRIMARILYlow libido, is common amongwomen, with prevalences of8 % to 50 % previously re-ported.1-3 The prevalence appears to increase with age from the third decade3 as well as after oophorec-tomy.4 Although multiple psychoso-cial and health factors contribute to low sexual desire and arousal,5 it has been proposed that endogenous androgen levels are significant inde-pendent determinants of sexual behav-ior in women.6,7 Most studies support a therapeutic benefit of testosterone for women experiencing hypoactive sexual desire disorder, and there is increasing use of testosterone for this purpose.8-10 It is widely believed that a low serum free testosterone level is the diagnostic marker for the cluster of symptoms described as characterizing “female androgen insufficiency”6 based on therapeutic trials8-11 and expert opinion.6,7,12 However, evidence that a low serum testosterone level distinguishes women with low sexual function from others, and that andro-gen deficiency syndrome can be defined biochemically, is lacking. Therefore, we have investigated whether low self-reported sexual func-tion, assessed using the validated Profile of Female Sexual Function (PFSF)13,14 in women aged 18 to 75 years randomly recruited from the community, is associated with low serum androgen levels